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General NPI Number Information
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NPI Number | 1881064194
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Entity Type | Organization
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Legal Business Name | TRANSITIONAL CARE ASSOCIATES AT HOME
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Dates
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Enumeration Date | 09/29/2015
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Last Update Date | 09/29/2015
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Provider Practice Location Address
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Address Line | 500 N RAINBOW BLVD SUITE 300
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City | LAS VEGAS
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State | NV
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Zip | 89107-1082
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Country | US
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Telephone | 702-450-1717
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Fax | 702-947-6740
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Provider Business Mailing Address
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Address Line | 500 N RAINBOW BLVD SUITE 300
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City | LAS VEGAS
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State | NV
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Zip | 89107-1082
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Country | US
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Telephone | 702-450-1717
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Fax | 702-947-6740
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Authorized Official
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Title or Position | MANAGER
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Name | KIM KOZLOWSKI
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Credential |
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Telephone | 702-450-1717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | NV20151504380
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License Number State | NV
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